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Meliyanie G, Andiarsa D. Program Eliminasi Lymphatic Filariasis Di

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Meliyanie G, Andiarsa D. Program Eliminasi Lymphatic Filariasis Di JHECDs, 3(2) 2017, hal .63-70 Review Program Eliminasi Lymphatic Filariasis di Indonesia Lymphatic Filariasis Elimination Program in Indonesia Gusti Meliyanie*, Dicky Andiarsa Balai Litbang P2B2 Tanah Bumbu, Kementerian Kesehatan RI Kawasan Perkantoran Pemerintah Daerah Kabupaten Tanah Bumbu, Kalimantan Selatan *Korespondensi: [email protected] DOI : http://dx.doi.org/10.22435/jhecds.v3iI2.1790 Tanggal masuk 10 Oktober 2017, Revisi pertama 22 Oktober 2017, Revisi terakhir 20 November 2017, Diterima 23 November 2017, Terbit daring 19 Januari 2018 Abstract. Filariasis has been a public health problem in Indonesia for a long time and WHO has established this disease as a neglected disease which is a public health problem in the world, therefore a global filariasis elimination program that must be achieved in 2020. This article compiles 44 literatures for writing references related to the development of global filariasis elimination and the progress of filariasis elimination in Indonesia particularly. Filariasis elimination program in Indonesia has been running at least 51 districts that have stopped implementing mass drug administration (MDA) from 236 endemic filariasis districts. The remaining districts are expected to have implemented MDA start from 2015 so that the year 2020 is completed and verified also given predicates of filariasis elimination according to global target of filariasis elimination. Management-based and community-based research is important to determine the best model of elimination. There are still many challenges in increasing coverage, so that sustainability education efforts on filariasis and the importance of treatment will motivate communities to play an active role in achieving maximum coverage targets, and national filariasis elimination targets can be achieved by 2020. Keywords: Filariasis Elimination, MDA, neglected disease, problem of public health. Abstrak. Filariasis telah menjadi masalah kesehatan masyarakat di Indonesia sejak lama dan WHO telah menetapkan penyakit ini sebagai penyakit yang terabaikan dan menjadi masalah kesehatan masyarakat di dunia, untuk itu dicanangkan program Eliminasi filariasis secara global dengan target eliminasi pada tahun 2020. Artikel ini menghimpun 44 literatur sebagai bahan utama penulisan terkait perkembangan eliminasi filariasis global secara umum dan kemajuan eliminasi filariasis di Indonesia khususnya. Program eliminasi filariasis di Indonesia sudah berjalan setidaknya ada 51 kabupaten yang telah berhenti melaksanakan POPM dari 236 kabupaten yang endemis filariasis. Kabupaten tersisa diharapkan sudah melaksanakan POPM sejak 2015 sehingga tahun 2020 selesai dan dilakukan verifikasi dan diberikan predikat eliminasi filariasis sesuai target global eliminasi filariasis. Penelitian berbasis manajemen dan komunitas penting dilakukan untuk menentukan model terbaik dalam eliminasi. Masih banyak tantangan dalam meningkatkan cakupan, karenanya upaya edukasi berkelanjutan tentang filariasis dan pentingnya pengobatan akan menggerakkan masyarakat untuk berperan aktif dalam pencapaian target cakupan secara maksimal, dan target eliminasi filariasis nasional dapat tercapai di tahun 2020. Kata kunci: Eliminasi filariasis, POPM, penyakit terabaikan, masalah kesehatan masyarakat. DOI : http://dx.doi.org/10.22435/jhecds.v3iI2.1790 Cara sitasi : Meliyanie G, Andiarsa D. Studi Literatur: Program Eliminasi Lymphatic Filariasis di (How to cite) Indonesia. J.Health.Epidemiol.Commun.Dis. 2017;3(2): 63-70. 63 G Melyanie, D Andiarsa Program Eliminasi Lymphatic Filariasis….. Pendahuluan Keputusan Menkes RI Nomor: 157/Menkes/SK/ X/2003 tentang Standar Pelayanan Minimal Bidang Lymphatic Filariasis (LF) telah menjadi masalah Kesehatan di Kabupaten/Kota yaitu kesehatan masyarakat di Indonesia sejak lama, Penatalaksanaan Kasus Kronis Filariasis dan bahkan sejak 1997 WHO telah menetapkan Keputusan Nomor: 1582/Menkes/SK/Xi/2005 penyakit ini sebagai neglected disease yang menjadi tentang Pedoman Pengendalian Filariasis (Penyakit masalah kesehatan masyarakat di dunia.1 Indonesia Kaki Gajah)6 yang kemudian digantikan dengan merupakan negara endemis LF satu-satunya di Permenkes No. 94 Tahun 2014 tentang dunia yang ditemukan tiga spesies cacing filaria Penanggulangan Filariasis pada tahun 2014. pada manusia yaitu: Wuchereria bancrofti, Brugia malayi dan Brugia timori2 yang dapat ditularkan oleh Program eliminasi filariasis yang diupayakan lima genera nyamuk: Aedes, Culex, Armigeres, Kemenkes telah diikuti oleh sebagian besar Mansonia dan Anopheles.3 LF ditemukan di hampir kabupaten terutama kabupaten/kota endemis seluruh provinsi di Indonesia dengan total kasus filariasis. Laporan tahun 2016 menyebutkan bahwa yang teregistrasi hingga tahun 2013 sebanyak dari 514 kabupaten/kota terdapat 236 11.912 kasus.3 kabupaten/kota yang endemis filariasis dan hanya 181 kabupaten/kota yang sedang melaksanakan Lymphatic filariasis secara umum tidak Pemberian Obat Pencegahan Massal (POPM) menyebabkan kematian, namun dapat filariasis 51 kabupaten/kota telah selesai mengakibatkan kecacatan permanen dan disabilitas melakukan POPM, dan dari 51 kabupaten/kota pada penderita sehingga dapat menurunkan yang selesai POPM, 8 Kabupaten/kota telah produktivitas dan berdampak langsung pada mendapatkan sertifikasi filariasis dan 43 lainnya perekonomian keluarganya. Bagi keluarga miskin, pada tahap Survey (preTAS danTAS).7 total kerugian ekonomi keluarga mencapai 67% dari total pengeluaran keluarga per bulan.4 Dari Proses tersebut masih sedang berlangsung untuk aspek psikologi, penyakit ini berdampak terhadap sebagian besar kabupaten/kota endemis dalam stigma sosial masyarakat terkait kekhawatiran upayanya mengentaskan penyakit filariasis hingga masyarakat sekitar penderita tentang penularan tidak lagi menjadi masalah kesehatan masyarakat di penyakit ini yang berujung pada pengucilan oleh wilayahnya. Artikel ini akan membahas progres masyarakat sehingga menambah beban psikologis kegiatan eliminasi filariasis di Indonesia meliputi penderita. sejarah dan awal mula penyakit ini serta upaya yang telah dilakukan oleh manusia hingga saat ini; Laporan P2PL untuk jumlah kasus klinis elefantiasis beberapa tantangan, hambatan dan kemungkinan terbanyak pada tahun 2009 terdapat di kabupaten potensi yang akan dihadapi dalam upaya eliminasi; Aceh Utara (1,353) selanjutnya diikuti oleh kebutuhan dasar dan komplementer untuk kabupaten Manokwari (667), Mappi (652), Sikka mensukseskan program eliminasi agar Indonesia 5 (619) dan Ende (244). Jumlah kabupaten/kota yang bisa terbebas dari salah satu penyebab masalah endemis filariasis tahun 2009 adalah 356 kesehatan masyarakat kita. kabupaten/kota dari 495 kabupaten/kota (71,9%) Artikel ini ditulis untuk mendeskripsikan dan 139 kabupaten/kota (28,1%) yang tidak perkembangan progam eliminasi filariasis di endemis filariasis.5 Daerah dengan microfilaria rate Indonesia, tantangan apa yang dihadapi, strategi tertinggi tahun 2009 adalah kabupaten yang dilakukan serta proyeksi kebutuhan dan Bonebolango (40%) selanjutnya diikuti oleh harapan target di tahun 2020. kabupaten Manokwari (38,57%) Kota Cilegon (37,50 %), Mamberamo Raya (31.46) dan Kutai Metode Kertanegara (26,00%).5 Artikel merupakan naskah yang berasal dari review Hampir 2 dekade yang lalu, WHO telah beberapa literatur rujukan yang diambil sebagai meluncurkan program eliminasi filariasis secara bahan utama penulisan. Beberapa peramban ilmiah global (Global Program to Eliminate Lymphatic dan publisher terindeks global digunakan untuk Filariasis/ GPELF) yang bertujuan untuk mengurangi mencari beberapa artikel ilmiah yang berkaitan kasus LF hingga tidak lagi menjadi masalah dengan Filariasis, program eliminasi filariasis kesehatan masyarakat di dunia pada tahun 2020. nasional dan global, sejarah, dan perkembangan Hal ini ditindaklanjuti oleh Kementerian Kesehatan program eliminasi yang telah dilakukan secara Republik Indonesia dengan mengeluarkan global. Peramban tersebut antara lain: Pubmed, 64 JHECDs Vol. 3, No. 2, Desember 2017 Google scholar, Springer, NCBI, PLos One dan menemukan mikrofilaria dalam darah; tahun 1896 WHO official website serta beberapa data utama Yushitaro Matsuura menemukan cacing betina tentang program eliminasi filariasis di Indonesia dewasa pada inguinal lymph node (di Kumamoto); yang didapatkan dari Pusdatin Kemenkes RI. dan tahun 1903 Shichiro Hida menemukan filaria Artikel yang didapatkan dipilah dan dipilih hanya jantan dalam hydrocele di kelenjar seminiferus yang relevan dengan topik artikel yang ditulis. bagian kiri.8 Artikel yang berhasil didapatkan sebanyak 65 Filariasis di Indonesia sendiri awalnya dilaporkan naskah dengan kata kunci Filariasis di Indonesia, Haga dan Van Eecke pada tahun 1889 di Jakarta Lymphatic filariasis, ancient filariasis, Global Program bahwa telah ditemukan penderita filariasis to Eliminate Lymphatic Filariasis/ GPELF, program skrotum.10 Tahun 1937 Brug menyimpulkan dalam nasional eliminasi filariasis, MDA/pengobatan laporannya tentang filariasis di seluruh Indonesia massal, dan Community empowerment to filariasis. pada waktu itu telah diketahui dua jenis cacing Dari naskah yang ditemukan hanya 44 dokumen filaria sebagai penyebabnya yaitu Wuchereria yang relevan terhadap tujuan dan topik penulisan. bancrofti (W. Bancrofti) dan Brugia malayi (B. malayi).10 Kasus filariasis pertama kali dilaporkan di Hasil Nusa Tenggara Timur pada tahun 1965 sebagai “filariasis timor”11,12 dan belum diketahui spesies Sejarah Filariasis penyebabnya hingga tahun 1977.13,14 Pada tahun itu Filariasis telah
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